| NPI | 1972891604 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHRYN FOWLER Senior VP, CFO 208-381-8717 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: ID 62) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: ID 62) |
| 207P00000X Emergency Medicine (Licence: ID 62) | |
| 207Q00000X Family Medicine (Licence: ID 62) | |
| 207V00000X Obstetrics & Gynecology (Licence: ID 62) | |
| 207X00000X Orthopaedic Surgery (Licence: ID 62) | |
| 208800000X Urology (Licence: ID 62) | |
| Enumeration Date | 2011-07-15 |
| Last Update Date | 2022-12-08 |